Risk factors associated with the practice of episiotomy and perineal tears occurred in mothers at the maternity hospital Sharif Idrissi in the region of Gharb Chrarda Bni Hssen (Morocco) (original) (raw)
2014, International Journal of Innovation and Applied Studies
The objective was to study the episiotomy and perineal tears in the service of Gynecology Obstetrics Health Centre Cherif Idrissi Kenitra the Gharb region. Analytical study on a sample of 327 women delivered. In this section, we have used standard statistical methods such as: chisquare test, calculating the coefficients of bond and to determine the factors that influence directly or indirectly on the practices of episiotomy, we adopted the analysis of logistic regression. This study has evaluated the rates and risks associated with the use of episiotomy and perineal tears. Respectively, an episiotomy 41.28% and a rate of perineal tears of 3.6%. In univariate analysis, four risk factors were associated with the occurrence of perineal tears; primiparity (8.1% vs 1.9%), the presentation of posterior release (21.4% vs 2.6%), episiotomy (5.9% vs 1.6%) and macrosomia (9 5 vs 2.5). Against by five factors were found as risk factors associated with the use of episiotomy, primiparity (60.5% vs 2% °, age class above the age of 21, the extraction sucker (62.5% vs 36.1%), the presentation of the previous release (42.5% vs 14.3%) and birth interval of less than 5 years (46.4% vs 18.3%). adjusted during the multivariate analysis only logistic regression primiparity and vacuum extraction were strongly associated with the use of episiotomy. If we can not recommend good thresholds of episiotomy, could act on these risk factors to the fetus or the mother are preventable, provided they are well taken care of throughout the early period ANC because this action is an element of great importance. But there are circumstances in which a prudent and appropriate clinical judgment dictate the obstetrician performing an episiotomy. It is obvious that preventive episiotomy is performed preferentially in situations of higher risk of tearing (large fetus fragile perineum, instrumental extraction ...).
Sign up for access to the world's latest research
checkGet notified about relevant papers
checkSave papers to use in your research
checkJoin the discussion with peers
checkTrack your impact
Sign up for access to the world's latest research
Related papers
Journal de gynécologie, obstétrique et biologie de la reproduction, 2014
To evaluate the perineal outcome after a major decrease in episiotomy rate in a high-risk (level III) maternity ward. This was a retrospective cohort study in a teaching high-risk maternity comparing perineal tears between 2003 and 2010. We included for analysis: pregnancies at 25 weeks or more, fetal birthweights of 500 g or more, vaginal deliveries in our maternity, singletons or multiple pregnancies, cephalic or breech presentations. The two populations were comparable. In 2003, we performed 18.8% of episiotomies and 1.3% in 2010. Between these years, our intact perineum rate increased from 28.8 to 37.5% (P<0.0001). We also report an increase in first and second degree perineum lesions (20.5% in 2003 and 40.2% in 2010, P<0.0001) and anterior perineal lesions (17.8% in 2003 and 30.3% in 2010, P<0.0001). We also report a significant decrease in perineal lesions with sphincter injuries (1% in 2003 and 0.3% in 2010 P<0.0001). Comparing 2003 to 2010, the majority of cases ...
International Journal of Innovation and Applied Studies, 2014
Identify parameters from maternal restrictions intrauterine growth and fetal macrosomia. Also from the birth weight and fundal height risk cesarean section. We have highlighted the limitations of growth and fetal macrosomia in mothers from its ranks obesity according to body mass index (BMI) and uterine size and the effect of BMI blood pressure and edema in the uterine height. Small birth weight and macrosomia are then at risk both from either the health of the child or her mother in case of big weight. While clinical identification of these two anomalies early growth should guide the pregnant woman to a specific treatment for the future delivery is not complicated or child, or for his mother.
2009
Recommendations for clinical practice (RPC) edited by the College of French gynecologists and obstetricians (CNGOF) claim for a more restrictive use of episiotomy. The aims of this study were to assess the impact of these recommendations on episiotomy practice and to evaluate maternal and neonatal outcomes of a more restrictive approach. We compared in a retrospective analysis episiotomy practice, maternal and neonatal consequences of a restrictive episiotomy policy between 2004 and 2006 (before and after recommendations publication) in a level III maternity unit. Identification of risks factors for episiotomy practice in our population was based on a multivariate analysis. Two thousand and five hundred and 2909 patients who delivered vaginally respectively in 2004 and 2006 were included. In 2006, fewer episiotomies were performed (43.48% vs 32.32%, p<0.0001) and more grade I and II perineal tears occurred (27.56% vs 36.61%, p=0.0001) whereas the anal sphincter tear rate remained constant (0.48% vs 0.69%, p=0.376). Neonatal condition assessed by the Apgar score was also stable. In multivariate analysis, risk factors for episiotomy already described in the literature were significant in our study and year 2006 was associated with less use of episiotomy in comparison with year 2004 (OR: 0.499; IC: 0.44-0.57; p<0.0001). In our institution, French guidelines were followed by a reduction in the use of episiotomy practice without increasing the risk for severe perineal tear or neonatal distress.
Journal de gynécologie, obstétrique et biologie de la reproduction, 2010
To evaluate our practice following Clinical Practice Guidelines (CPG) of the French College of Obstetricians and Gynecologists (CNGOF) in 2005 advocating a policy of restrictive episiotomy and to show that a significative decrease in the rate of episiotomy does not increase the number of third and fourth degree perineal tears. A retrospective study of episiotomies and third/fourth degree perineal tears of the year 2003 (before the CPG) was compared with the year 2007 (after the CPG). We analyzed the indications of episiotomies and compared the rate of episiotomies and severe perineal tears between the two periods. In 2003, the rate of episiotomies was 18.8% (upon 1755 vaginal deliveries). We observed 16 (9 per thousand) third-degree perineal tears, five of which was associated with episiotomies; and two (1 per thousand) fourth-degree perineal tears. In 2007, the rate of episiotomies was 3.4% (upon 1940 vaginal deliveries). There were eight (4 per thousand) third-degree and four (2 p...
2019
The objective of this study was to determine the rate of neonatal mortality and to identify risk factors for neonatal death. This retrospective study has been conducted by using all of the 252 files of new-borns who died between 0 and 28 days at Pagnon Mother-Child Hospital in Meknes (Morocco) in 2016. The data collection was carried out using an exploitation sheet. The neonatal mortality rate was 19%. Prematurity was the most important risk factor for death. Early neonatal mortality is common among females. The vaginal way, maternal age between 20 and 35 years was the main maternal factors. Improving this situation requires women's education, seminar reinforcement and continuous training of midwives, doctors and nurses. Encouraging research on neonatal mortality is also essential.
[Evolution of maternal mortality in a level 3 Tunisian maternity from 1998 to 2007]
Journal de gynécologie, obstétrique et biologie de la reproduction, 2009
The action plan for the maternal mortality is generally based on research studies' results carried out within hospital structure. Determination and follow-up of the evolution of maternal mortality from 1998 to 2007 in a level 3 Tunisian maternity and identification of its main causes. It is a retrospective study carried out between January 1998 and December 2007. In our service, since 1984, maternal deaths are systematically recorded. Information about deaths are collected from the following sources: childbirth folder, folder of hospitalization in reanimation, after the autopsy, through information collected beside the family, or by the National System of Maternal Death Surveillance, only since 1999. Thirty-one mother deaths were colligated during the study. The average age of patients was around 33 years. The global maternal mortality rate during the study was about 56 deaths for 100,000 live births. The trend was characterized by a net decrease to this rate to 2003, and stagna...
Pan African Medical Journal, 2015
L'hémorragie grave du péripartum demeure une des causes principales de mortalité maternelle. L'objectif de notre étude était de décrire le profil épidémiologique des patientes qui ont été prises en charge en milieu de réanimation suite à une hémorragie grave du péripartum et de rechercher d'éventuels facteurs de risque de mortalité. Notre étude est rétrospective descriptive et analytique. Nous avons inclus tous les cas d'hémorragie du péripartum ayant séjourné en unité de réanimation obstétricale du centre de maternité et de néonatologie de Tunis (CMNT) au cours de la période allant de janvier 2010 à Décembre 2013. Nous avons recueilli les paramètres démographiques, obstétricaux, ceux relatifs à la prise en charge chirurgicale et réanimatoire, les scores de gravité SAPS obstétrical et APACHEII, ainsi que la morbi-mortalité. Au total nous avons colligé 322 cas sur quatre ans. La répartition annuelle des patientes ainsi que les caractéristiques démographiques et obstétricales étaient comparables dans leur globalité sur les quatre années. Les pratiques thérapeutiques étaient également comparables. Le taux global de mortalité par hémorragie dans notre unité était à 4,7%, avec un taux annuel de mortalité stable. L'analyse des facteurs de risque de mortalité par hémorragie en milieu de réanimation a montré une association statistiquement significative entre la survenue du décès et les facteurs suivants : recours aux catécholamines, survenue de sepsis, oedème pulmonaire aigu, coagulation intravasculaire disséminée, insuffisance rénale aigue avec recours à l'hémodialyse, SDRA ou TRALI, atteinte neurologique grave, défaillance multiviscérale et arrêt cardiaque récupéré.
Factors associated with perinatal mortality at the Dr Rau/Ciriri hospital
CiririSummaryPurpose. — To determine factors associated with perinatal mortality to the Dr Rau hospital.Methods. — A case control study was conducted at Dr Rau hospital from January 1st to December31 2012 with a proportion of a case for two controls and 273 medical files have been exploited.A logistical regression permitted to identify factors associated with perinatal mortality. Caseswere stillbirths and early neonatal deaths. Controls were live newborns discharged from thehospital.Results. — Thirty-two perinatal deaths/1000 live births were registered. The main factors asso-ciated with perinatal mortality were maternal associated diseases, fetal hypotrophy, advancedmaternal age, prematurity and insufficient antenatal care (P < 0.05).Conclusion. — The struggle against the perinatal mortality passes by an organization of theprenatal consultations of quality and a follow-up brought closer of women in postpartum.
Profil Épidémiologique Des Avortements Provoqués Au Maroc (1992/2014)
On the set of the poisonings brought together in the the Moroccan Anti Poison Control Center (MPCC) for a period spread on 22ans (1992/2014), 169 cases of abortion caused by poisoning were recorded. The objective of this work is to describe the epidemiological characteristics and to determine the specific lethality of abortions caused in Morocco between 1992 and 2014 by basing itself on a retrospective study of the cases of abortions. During this period 169 cases of abortion caused by poisoning were declared to the MPCC by means of telephone and mail, the region which knew the maximum of the cases is Rabat Salé Zemmour Zair, the environment rural prevail the risks of abortion with 90 %, the average age was 28,09±11,81, the evolution is generally positive.
Loading Preview
Sorry, preview is currently unavailable. You can download the paper by clicking the button above.